Clip applier adapted for use with a surgical robot

ABSTRACT

A clip applier adapted for use with a surgical robot is disclosed. The clip applier comprises a shaft having clips stored therein and jaws adapted for receiving a clip from the shaft. The shaft is in mechanical communication with a robotic mounting portion. The robotic mounting portion contains a gear drive assembly for rotating the shaft, feeding clips into the jaws and forming clips in the jaws.

BACKGROUND

The present disclosure relates generally to the field of roboticsurgery. In particular, the present disclosure relates to, although notexclusively, robotically controlled surgical instruments. Moreparticularly, the present disclosure relates to, although notexclusively, robotically controlled clip applier instruments havingrobotically controlled features for robotically feeding and formingsurgical clips the surgical instrument.

Many surgical procedures require ligating blood vessels or otherinternal tissue. Many surgical procedures are performed using minimallyinvasive techniques where a hand-held instrument is used by the surgeonto perform the cutting or ligating.

BRIEF DESCRIPTION OF THE DRAWINGS

The invention will be more fully understood from the following detaileddescription taken in conjunction with the accompanying drawings, inwhich:

FIG. 1 is an isometric view of a robotic master control station;

FIG. 2 is an isometric view of a robotic arm cart;

FIG. 3 is a cross-sectional view of a robotic arm assembly;

FIG. 4 is an isometric view of an alternative robotic arm cart;

FIG. 5 is a top isometric view of a surgical tool drive assembly adaptedfor use with a robotic surgical system;

FIG. 6 is a bottom isometric view of a surgical tool drive assemblyadapted for use with a robotic surgical system;

FIG. 7 is an exploded view of a clip applier shaft adapted for use witha surgical tool drive assembly;

FIG. 8 is an exploded view of a first expression of a surgical tooldrive assembly adapted for use with a robotic surgical system;

FIG. 9A is an assembly view of the FIG. 8 expression rotation mechanism;

FIG. 9B is an isometric view of the FIG. 8 rotation mechanism inoperation;

FIG. 10A is an assembly view of the FIG. 8 expression clip feedmechanism

FIG. 10B is an isometric view of the FIG. 8 clip feeding mechanism inoperation

FIG. 11A is an assembly view of the FIG. 8 expression clip formingmechanism;

FIG. 11B is an isometric view of the FIG. 8 clip forming mechanism inoperation;

FIG. 12 is an exploded view of a second expression of a surgical tooldrive assembly adapted for use with a robotic surgical system;

FIG. 13A is an assembly view of the FIG. 12 expression rotationmechanism;

FIG. 13B is an isometric view of the FIG. 12 rotation mechanism inoperation;

FIG. 14A is an assembly view of the FIG. 12 expression clip feedmechanism;

FIG. 14B is an isometric view of the FIG. 12 clip feeding mechanism inoperation;

FIG. 15A is an assembly view of the FIG. 12 expression clip formingmechanism;

FIG. 15B is an isometric view of the FIG. 12 clip forming mechanism inoperation;

FIG. 16 is an exploded view of a third expression of a surgical tooldrive assembly adapted for use with a robotic surgical system;

FIG. 17A is an assembly view of the FIG. 16 expression rotationmechanism;

FIG. 17B is an isometric view of the FIG. 16 rotation mechanism inoperation;

FIG. 18A is an assembly view of the FIG. 16 expression clip feedmechanism;

FIG. 18B is an isometric view of the FIG. 16 clip feeding mechanism inoperation;

FIG. 19A is an assembly view of the FIG. 16 expression clip formingmechanism; and

FIG. 19B is an isometric view of the FIG. 16 clip forming mechanism inoperation.

DETAILED DESCRIPTION OF THE INVENTION

Uses of the phrases “in various embodiments,” “in some embodiments,” “inone embodiment”, or “in an embodiment”, or “in an expression” or thelike, throughout the specification are not necessarily all referring tothe same embodiment. Furthermore, the particular features, structures,or characteristics of one or more embodiments may be combined in anysuitable manner in one or more other embodiments. Such modifications andvariations are intended to be included within the scope of the presentinvention.

The present invention generally provides a surgical clip applier andmethods for using a surgical clip applier to apply surgical clips to avessel, duct, shunt, etc., during a surgical procedure. An exemplarysurgical clip applier can include a variety of features to facilitateapplication of a surgical clip, as described herein and illustrated inthe drawings. However, a person skilled in the art will appreciate thatthe surgical clip applier can include only some of these features and/orit can include a variety of other features known in the art. Thesurgical clip applier described herein is merely intended to representcertain exemplary embodiments.

Over the years a variety of minimally invasive robotic (or“telesurgical”) systems have been developed to increase surgicaldexterity as well as to permit a surgeon to operate on a patient in anintuitive manner. Many of such systems are disclosed in the followingU.S. Patents which are each herein incorporated by reference in theirrespective entirety: U.S. Pat. No. 5,792,135, entitled “ArticulatedSurgical Instrument For Performing Minimally Invasive Surgery WithEnhanced Dexterity and Sensitivity”, U.S. Pat. No. 6,231,565, entitled“Robotic Arm DLUS For Performing Surgical Tasks”, U.S. Pat. No.6,783,524, entitled “Robotic Surgical Tool With Ultrasound Cauterizingand Cutting Instrument”, U.S. Pat. No. 6,364,888, entitled “Alignment ofMaster and Slave In a Minimally Invasive Surgical Apparatus”, U.S. Pat.No. 7,524,320, entitled “Mechanical Actuator Interface System ForRobotic Surgical Tools”, U.S. Pat. No. 7,691,098, entitled Platform LinkWrist Mechanism”, U.S. Pat. No. 7,806,891, entitled “Repositioning andReorientation of Master/Slave Relationship in Minimally InvasiveTelesurgery”, and U.S. Pat. No. 7,824,401, entitled “Surgical Tool WithWristed Monopolar Electrosurgical End Effectors”. Many of such systems,however, have in the past been unable to mechanically ligate vessels andtissue.

FIG. 1 depicts one version of a master controller 1001 that may be usedin connection with a robotic arm slave cart 2001 of the type depicted inFIG. 2. Master controller 1001 and robotic arm slave cart 2001, as wellas their respective components and control systems are collectivelyreferred to herein as a robotic system 1000. Examples of such systemsand devices are disclosed in U.S. Pat. No. 7,524,320 which has beenherein incorporated by reference. Thus, various details of such deviceswill not be described in detail herein beyond that which may benecessary to understand various embodiments and forms of the presentinvention. As is known, the master controller 1001 generally includescontrollers (generally represented as 1003 in FIG. 1) which are graspedby the surgeon and manipulated in space while the surgeon views theprocedure via a stereo display 1002. The master controllers 1001generally comprise manual input devices which preferably move withmultiple degrees of freedom, and which often further have an actuatablehandle for actuating tools (for example, for closing graspinginstruments, applying an electrical potential to an electrode, or thelike).

As can be seen in FIG. 2, in one form, the robotic arm cart 2001 isconfigured to actuate a plurality of surgical tools, generallydesignated as 2002. Various robotic surgery systems and methodsemploying master controller and robotic arm cart arrangements aredisclosed in U.S. Pat. No. 6,132,368, entitled “Multi-ComponentTelepresence System and Method”, the full disclosure of which isincorporated herein by reference. In various forms, the robotic arm cart2001 includes a base 2008 from which, in the illustrated embodiment,three surgical tools 2002 are supported. In various forms, the surgicaltools 2002 are each supported by a series of manually articulatablelinkages, generally referred to as set-up joints 2004, and a roboticmanipulator 2006. These structures are herein illustrated withprotective covers extending over much of the robotic linkage. Theseprotective covers may be optional, and may be limited in size orentirely eliminated in some embodiments to minimize the inertia that isencountered by the servo mechanisms used to manipulate such devices, tolimit the volume of moving components so as to avoid collisions, and tolimit the overall weight of the cart 2001. Cart 2001 will generally havedimensions suitable for transporting the cart 2001 between operatingrooms. The cart 2001 may be configured to typically fit through standardoperating room doors and onto standard hospital elevators. In variousforms, the cart 2001 would preferably have a weight and include a wheel(or other transportation) system that allows the cart 2001 to bepositioned adjacent an operating table by a single attendant.

Referring now to FIG. 3, in at least one form, robotic manipulators 2006may include a linkage 3008 that constrains movement of the surgical tool2002. In various embodiments, linkage 3008 includes rigid links coupledtogether by rotational joints in a parallelogram arrangement so that thesurgical tool 2002 rotates around a point in space 3010, as more fullydescribed in issued U.S. Pat. No. 5,817,084, the full disclosure ofwhich is herein incorporated by reference. The parallelogram arrangementconstrains rotation to pivoting about an axis 3012 a, sometimes calledthe pitch axis. The links supporting the parallelogram linkage arepivotally mounted to set-up joints 2004 (FIG. 2) so that the surgicaltool 2002 further rotates about an axis 3012 b, sometimes called the yawaxis. The pitch and yaw axes 3012 a, 3012 b intersect at the remotecenter 3014, which is aligned along a shaft 3008 of the surgical tool12002. The surgical tool 2002 may have further degrees of driven freedomas supported by manipulator 2006, including sliding motion of thesurgical tool 2002 along the longitudinal tool axis “LT-LT”. As thesurgical tool 2002 slides along the tool axis LT-LT relative tomanipulator 2006 (arrow 3012 c), remote center 3014 remains fixedrelative to base 3016 of manipulator 2006. Hence, the entire manipulatoris generally moved to re-position remote center 3014. Linkage 3008 ofmanipulator 2006 is driven by a series of motors 3020. These motorsactively move linkage 3008 in response to commands from a processor of acontrol system. As will be discussed in further detail below, motors3020 are also employed to manipulate the surgical tool 2002.

An alternative set-up joint structure is illustrated in FIG. 4. In thisembodiment, a surgical tool 2002 is supported by an alternativemanipulator structure 2006′ between two tissue manipulation tools. Thoseof ordinary skill in the art will appreciate that various embodiments ofthe present invention may incorporate a wide variety of alternativerobotic structures, including those described in U.S. Pat. No.5,878,193, entitled “Automated Endoscope System For OptimalPositioning”, the full disclosure of which is incorporated herein byreference. Additionally, while the data communication between a roboticcomponent and the processor of the robotic surgical system is primarilydescribed herein with reference to communication between the surgicaltool 2002 and the master controller 1001, it should be understood thatsimilar communication may take place between circuitry of a manipulator,a set-up joint, an endoscope or other image capture device, or the like,and the processor of the robotic surgical system for componentcompatibility verification, component-type identification, componentcalibration (such as off-set or the like) communication, confirmation ofcoupling of the component to the robotic surgical system, or the like.

An exemplary non-limiting surgical tool 2002 that is well-adapted foruse with a robotic system 1000 that has a tool drive assembly 5000 thatis operatively coupled to a master controller 1001 that is operable byinputs from an operator (i.e., a surgeon) is depicted in FIG. 5. As canbe seen in that Figure, the surgical tool 5000 includes a surgical endeffector 5004 that comprises a clip applier. In at least one form, thesurgical tool 5000 generally includes an elongated shaft assembly 5001that has a distal jaw assembly 5004. The surgical tool 5000 is operablycoupled to the manipulator by a tool mounting portion, generallydesignated as 5003. The surgical tool 5000 further includes an interface6010 (see FIG. 6) which mechanically and electrically couples the toolmounting portion 5003 to the manipulator. In various embodiments, thetool mounting portion 5003 includes a tool mounting plate 5003 a thatoperably supports a plurality of (four are shown in FIG. 6) rotatablebody portions, driven discs or elements 6020, that each include a pairof pins 6030 that extend from a surface of the driven element 6020. Onepin 6030 may be closer to an axis of rotation of each driven elements6020 than the other pin 6030 on the same driven element 6020, which mayhelp to ensure positive angular alignment of the driven element 6020.Interface 6010 is adapted to engage a mounting surface on arm 2006. Themounting portion 5003 may include an array of electrical connecting pins(not shown) which may be coupled to an electrical connection on arm2006, as is known and understood in the art. While interface 5003 isdescribed herein with reference to mechanical, electrical, and magneticcoupling elements, it should be understood that a wide variety oftelemetry modalities might be used, including infrared, inductivecoupling, or the like.

FIG. 7 illustrates an exploded view of one exemplary surgical clipapplier shaft 5001 and jaw assembly 5004. Such clip applier assemblieshave previously been described in U.S. Pat. No. 7,261,724 entitled“Surgical Clip Advancement Mechanism”, U.S. Pat. No. 7,288,098 entitled“Force Limiting Mechanism For Medical Instrument”, U.S. Pat. No.7,297,149 entitled “Surgical Clip Applier Methods”, U.S. Pat. No.7,686,820 entitled “Surgical Clip Applier Ratchet Mechanism”, U.S. Pat.No. 7,699,860 entitled “Surgical Clip”, and U.S. Pat. No. 7,731,724entitled “Surgical Clip Advancement and Alignment Mechanism” the entirecontents of which are herein incorporated by reference. The variouscomponents will be described in more detail below.

The shaft 5001 includes an outer tube 7010 that houses the shaftcomponents, which can include a jaw retaining assembly 7020 having a jawretainer shaft 7030 with a clip track 7040 and a push rod channel 7050formed thereon. The jaws 7060 can be configured to mate to a distal endof the clip track 7040. The shaft assembly 5001 can also include a clipadvancing assembly, which in one exemplary embodiment can include afeeder shoe 7070 that is adapted to be slidably disposed within the cliptrack 7040 to advance a series of clips 7080 positioned therein, and afeed bar 7090 that is adapted to drive the feeder shoe 7070 through theclip track 7040. The feed bar 7090 can include an advancer assembly 7100that is adapted to mate to a distal end thereof for advancing adistal-most clip into the jaws 7060. The shaft assembly 5001 can alsoinclude a clip forming or camming assembly, which in one exemplaryembodiment can include a cam 7120 that is adapted to slidably mate tothe jaws 7060, and a push rod 7130 that can couple to the cam 7120 tomove the cam 7120 relative to the jaws 7060. The shaft assembly can alsoinclude a tissue stop 7140 that can mate to a distal end of the cliptrack 7040 for facilitating positioning of the jaws 7060 relative to asurgical site.

Referring still to FIG. 7, the jaw retaining assembly 7020 is shown andit includes an elongate, substantially planar jaw retainer shaft 7030having a proximal end 7030 a that mates to the outer tube 7010, and adistal end 7030 b that is adapted to mate to the jaws 7060. While avariety of techniques can be used to mate the proximal end 7030 a of thejaw retainer shaft 7030 to the outer tube 7010, in the illustratedembodiment the proximal end 7030 a includes teeth 7035 formed on opposedsides thereof that are adapted to be received within corresponding holesor openings (not shown) formed in the outer tube 7010, and a cut-out7036 formed therein that allows the opposed sides of the proximal end7030 a to deflect or to form a spring. In particular, the cut-out 7036allows the opposed sides of the proximal end 7030 a of the jaw retainershaft 7030 to be compressed toward one another when the jaw retainershaft 7030 is inserted in the outer tube 7010. Once the teeth 7035 arealigned with the corresponding openings in the outer tube 7010, theproximal end 7030 a of the jaw retainer shaft 7030 will return to itsoriginal, uncompressed configuration thereby causing the teeth 7035 toextend into the corresponding openings to engage the outer tube 7010.

A variety of techniques can also be used to mate the distal end 7030 bof the jaw retainer shaft 7030 to the jaws 7060, however in theillustrated embodiment the distal end 7030 b of the jaw retainer shaft7030 includes several cut-outs or teeth 7035 formed therein for matingwith corresponding protrusions or teeth 7060 b formed on the jaws 7060.The teeth 7035 allow a proximal portion of the jaws 7060 to besubstantially co-planar with the jaw retainer shaft 7030.

The jaw retaining assembly 7020 can also include a push rod channel 7050formed thereon for slidably receiving the push rod 7130, which is usedto advanced the cam 7120 over the jaws 7060. The push rod channel 7050can be formed using a variety of techniques, and it can have any shapeand size depending on the shape and size of the push rod 7130. As shown,the push rod channel 7050 is fixedly attached, e.g., by welding, to asuperior surface of the retainer shaft 7030, and it has a substantiallyrectangular shape and defines a pathway extending therethrough. The pushrod channel 7050 can also extend along all or only a portion of theretainer shaft 7030. A person skilled in the art will appreciate thatthe jaw retaining assembly 7020 does not need to include a push rodchannel 7050 for facilitating movement of the push rod 7130 within theelongate shaft 5001 of the surgical clip applier 5000.

The jaw retaining assembly 7020 can also include a clip track 7040 matedthereto or formed thereon. The clip track 7040 is mated to an inferiorsurface of the jaw retainer shaft 7030, and it extends distally beyondthe distal end 7030 b of the jaw retainer shaft 7030 to allow a distalend of the clip track 7040 to be substantially aligned with the jaws7060. In use, the clip track 7040 is configured to seat at least one,and preferably a series, of clips therein. Accordingly, the clip track7040 can include opposed side rails that are adapted to seat opposedlegs of one or more clips therein, such that the legs of the clips areaxially aligned with one another. In an exemplary embodiment, the cliptrack 7040 can be configured to seat about twenty clips that arepre-disposed within the clip track 7040 during manufacturing. A personskilled in the art will appreciate that the shape, size, andconfiguration of the clip track 7040 can vary depending on the shape,size, number and configuration of clips, or other closure devices suchas staples, adapted to be received therein. Moreover, a variety of othertechniques can be used, instead of a clip track 7040, to retain a clipsupply with the elongate shaft 5001.

The clip track 7040 can also include several openings formed therein forreceiving a tang 7070 a formed on a feeder shoe 7070 adapted to bedisposed within the clip track 7040. In an exemplary embodiment, theclip track 7040 includes a quantity of openings that corresponds to atleast the number of clips adapted to be pre-disposed within the device5000 and applied during use. The openings are preferably equidistantfrom one another to ensure that the tang 7070 a on the feeder shoe 7070engages an opening each time the feeder shoe 7070 is advanced. While notshown, the clip track 7040 can include detents, rather than openings, orit can include other features that allow the clip track 7040 to engagethe feeder shoe 7070 and prevent distal movement, yet allow proximalmovement, of the feeder shoe 7070. The clip track 7040 can also includea stop tang formed thereon that is effective to be engaged by acorresponding stop tang formed on the feeder shoe 7070 to preventmovement of the feeder shoe 7070 beyond a distal-most position. The stoptang can have a variety of configurations, but in one exemplaryembodiment it is in the form of two adjacent tabs that extend toward oneanother to enclose a portion of the clip track, thus allowing clips topass therethrough.

To facilitate proximal movement of the feeder shoe 7070 within the cliptrack 7040, the feeder shoe 7070 can also include a tang 7070 b formedon the inferior surface thereof for allowing the feeder shoe 7070 to beengaged by the feed bar 7090 as the feed bar 7090 is moved distally. Theinferior tang 7070 b is similar to the superior tang 7070 a in that itcan be angled proximally. In use, each time the feed bar 7090 is moveddistally, a detent formed in the feed bar 7090 can engage the inferiortang 7070 b and move the feeder shoe 7070 distally a predetermineddistance within the clip track 7040. The feed bar 7090 can then be movedproximally to return to its initial position, and the angle of theinferior tang 7070 b will allow the tang to slide into the next detentformed in the feed bar 7090. A variety of other features rather thantangs and openings or detents can be used to control movement of thefeeder shoe 7070 within the clip track 7040.

As previously mentioned, the feeder shoe 7070 can also include a stopformed thereon that is adapted to stop movement of the feeder shoe 7070when the feeder shoe 7070 is in the distal-most position and there areno clips remaining in the device 5000. While the stop can have a varietyof configurations, a third tang may be formed on the feeder shoe 7070and extending in an inferior direction for engaging a stop tang formedon the clip track 7040, as is known and understood in the art. The thirdtang is positioned such that it will engage the stop tang 7090 a on theclip track 7040 when the feeder shoe 7070 is in a distal-most position,thereby preventing movement of the feeder shoe 7070 and the feed bar7090 when the clip supply is depleted.

As shown, the feed bar 7090 has a generally elongate shape with proximaland distal ends. The proximal end of the feed bar 7090 can be adapted tomate to a feed bar coupler 7200. The feed bar coupler 7200 can mate to avariety of feed links that are effective, upon actuation, to slidablymove the feed bar 7090 in a distal direction within the elongate shaft5001, 7010 thereby advancing a clip into the jaws 7060.

Still referring to FIG. 7, an exemplary embodiment of the jaws 7060 areshown. As previously mentioned, the jaws 7060 can include a proximalportion having teeth 7060 b for mating with corresponding teeth 7035formed on the jaw retaining shaft 7030. Other techniques can, however,be used to mate the jaws 7060 to the jaw retaining shaft 7030. Forexample, a dovetail connection, a male-female connection, etc., can beused. Alternatively, the jaws 7060 can be integrally formed with theretaining shaft 7030. The distal portion of the jaws 7060 can be adaptedto receive a clip therebetween, and thus the distal portion can includefirst and second opposed jaw members that are movable relative to oneanother. In an exemplary embodiment, the jaw members are biased to anopen position, and a force is required to move the jaw members towardone another. The jaw members can each include a groove formed therein onopposed inner surfaces thereof for receiving the legs of a clip inalignment with the jaw members. The jaws members can also each include acam track formed therein for allowing the cam 7120 to engage the jawmembers and move the jaw members toward one another. In an exemplaryembodiment, the cam track is formed on a superior surface of the jawmembers.

An exemplary cam 7120 for slidably mating to and engaging the jawmembers is depicted in FIG. 7. The cam 7120 can have a variety ofconfigurations, but in the illustrated embodiment it includes a proximalend 7120 a that is adapted to mate to a push rod 7130, and a distal endadapted to engage the jaw members. A variety of techniques can be usedto mate the cam 7120 to the push rod 7130, but in the illustratedexemplary embodiment the cam 7120 includes a female or keyed cut-outformed therein and adapted to receive a male or key member 7130 a formedon the distal end of the push rod 7130. As shown, the male member 7130 ahas a shape that corresponds to the shape of the cut-out to allow thetwo members 7120, 7130 to mate. A person skilled in the art willappreciate that the cam 7120 and the push rod 7130 can optionally beintegrally formed with one another. The proximal end 7130 b of the pushrod 7130 can be adapted to mate to a closure link assembly, for movingthe push rod 7130 and the cam 7120 relative to the jaws 7060.

While a variety of techniques can be used, in the illustrated exemplaryembodiment the distal end 7120 b includes a camming channel or taperingrecess formed therein for slidably receiving the cam tracks on the jawmembers. In use, the cam 7120 can be advanced from a proximal position,in which the jaw members are spaced a distance apart from one another,to a distal position, in which the jaw members are positioned adjacentto one another and in a closed position. As the cam 7120 is advancedover the jaw members the tapering recess will push the jaw memberstoward one another, thereby crimping a clip disposed therebetween.

Referring now to FIG. 8, an exploded view of one expression of clipapplier 5000 is shown. In this expression, the clip applier 5000includes rotatable bodies or spools 8010 a, 8010 b, 8010 c and arecoupled to rotatable bodies or drive elements 6020. The spools 8010a,b,c may be formed integrally with the driven elements 6020. In otherexpressions, spools may be formed separately from the driven elements6020 provided that the spools 8010 a,b,c and the elements 6020 arefixedly coupled such that driving the elements 6020 causes rotation ofthe spools 8010 a,b,c. Each spool 8010 a,b,c is coupled to a gear trainor drive assembly for translating motion to the shaft 7010 (or outertube) for rotating the shaft, advancing a clip and forming a clip. Asshown, spools 8010 a,b,c interface with spool bearings 8030 seatedbetween spools 8010 a,b,c and mounting plate 5003 a to facilitate smoothtransfer of rotational forced from corresponding drive elements on therobotic arm 2006. The bearings 8030 may further be provided to supportand stabilize the mounting of spools 8010 a,b,c and reduce rotaryfriction of shaft and gears, for example.

In the FIG. 8 expression, the tool mounting portion 5003 of the clipapplier 5000 comprises a shaft assembly rotation mechanism. In theillustrated expression, for example, the surgical tool 5000 comprises afirst spiral worm gear 8020 coupled to a rotatable body 6020 and asecond spiral worm gear 8015 coupled to the shaft assembly 5001. Abearing 8030 is coupled to a spool 8010 a and is provided between adriven element 8010 a and the mounting plate 6010. The first spiral wormgear 8020 is meshed to the second spiral worm gear 8015, which iscoupled to the shaft assembly 5001, to control the rotation of the shaftassembly 5001 in a clockwise (CW) and counter-clockwise (CCW) directionbased on the rotational direction of the first and second spiral wormgears 8015 and 8020. Accordingly, rotation of the first spiral worm gear8020 about a first axis is converted to rotation of the second spiralworm gear 8015 about a second axis, which is orthogonal to the firstaxis. As shown in FIGS. 9A and 9B, for example, a CCW rotation of thespool 8010 a results in the first spiral worm gear 8020 rotating in aCCW direction which in turn rotates the shaft assembly 5001 in thedirection indicated in FIG. 9A which is CW. It is appreciated that thespool may be rotated incrementally to provide precise rotation of theshaft. Such precise rotation may be enabled by an electrical interfacebetween the user console 1000 and clip applier 5000 driven by a softwarealgorithm, as is known and understood in the art. Shaft 5001 may berotatably fixed to mounting assembly 5010 by means of bearing clamp8040, comprised of clamp halves 8040 a and 8040 b. Shaft 5001 isprovided with a shaft collar 8050 that is fixedly attached to shaft 5001and worm gear 8015 that permits transfer of rotational force from wormgear 8015 to shaft 5001. Clamp halves 8040 a and 8040 b act as a bearingand enclose shaft collar 8050 and are provided with recesses to permitfree rotation of shaft 5001 while prohibiting shaft 5001 linear motion.In the present expression, clamp collar 8050 is a provided with anannular flange 8050 b to mate with clamp 8040 recesses prevent axialmotion.

Still referring to the FIG. 8 expression, tool mounting portion 5003 ofclip applier 5010 comprises a clip feed mechanism to feed clips intojaws 7060. In the illustrated expression for example, the surgical tool5000 comprises a rack and pinion gearing mechanism to provide the clipfeed functionality. A feeding gear 8100 is coupled to a spool 8010 csuch that rotation of the corresponding driven element 6020 causes thespool 8010 c and feed gear 8100 to rotate in a first direction. In theFIG. 8 expression, the feed gear 8100 is a pinion gear meshed to a feedrack gear 8110, which moves in a linear direction. The rack gear 8110 iscoupled to feedbar coupler 7200 by pins 8110 a, which is fixedlyattached to feedbar 7030, as was described above. As shown, feeding rack8110 is provided with a cut-out portion configured to nestle with asimilar cut-out portion on forming rack 8200 such that the feeding andforming rack together encircle shaft 5001, have a contiguous outerdiameter, yet move independent of one-another. Feed rack 8110 isconfigured with an annular portion where a portion of the annular outersurfaces comprises the rack teeth. The feed rack 8110 further comprisesa flange portion adapted to slideably mate with a similar flange onforming rack 8200. Tool mounting portion is further provided with a rackslide 8210, and rack channel (not shown) located in cover 8000 adaptedto receive feed rack 8110 and form rack 8200 flanges together andadapted to hold feeding rack 8110 and forming rack 8200 in a fixedrotational position relative to tool mounting portion 5003 whilepermitting linear movement.

In operation, referring to FIGS. 10A and 10B, the feed pinion 8100 ismeshed with feed rack 8110 in tool mounting portion 5003. Feed spool8010 c is rotated in a CCW direction which in turn rotates feed pinion8100 in a counter-clockwise direction. In the present expression, feedpinion 8100 is rotated sufficiently to advance rack 8110 distally asufficient distance to fully advance a clip into the jaws 7060. Rack8110 travel distance may vary based upon several factors e.g. clip leglength, jaw length. In the present expression, feed rack travelsapproximately 0.25 inches. Feed pinion 8100 rotation may be preciselycontrolled by an electrical and software interface to deliver the exactfeed rack 8110 travel necessary to feed a clip into the jaws 7060. Upondelivery of a clip into the jaws or after a predetermined amount ofrotation of feed pinion 8100, rotation of pinion 8100 is reversed to aCW direction to move feed rack 8110 in a proximal direction, in turnmoving feedbar coupler 7200 proximally, which in turn moves feedbar 7030proximally, as was described above. This process may be repeated severaltimes to accommodate a predetermined number of clips residing in theshaft. The software interface may be programmed to count down the numberof clips fed into the jaws and display the same to the user and mayfurther prevent the user from attempting to feed another clip once theshaft is empty. It is contemplated that the software interface may alertthe user when the shaft contains a predetermined amount of clips.

Referring back to FIG. 8, tool mounting portion 5003 of clip applier5000 comprises a clip forming mechanism to form clips in jaws 7060. Inthe illustrated expression for example, the surgical tool 5000 comprisesa rack and pinion gearing mechanism to provide the clip formingfunctionality. A forming gear 8300 is coupled to a spool 8010 b suchthat rotation of the corresponding driven element 6020 causes the spool8010 b and forming gear 8300 to rotate in a first direction. In the FIG.8 expression, the forming gear 8300 is a pinion gear meshed to a feedrack gear 8200, which moves in a linear direction. The rack gear 8200 iscoupled to male end 7130 b of pushrod 7130, as was described above andis locked in place about shaft 5001 with an assembly lock 8400. Asshown, forming rack 8200 is configured to nestle with feeding rack 8110such that the feeding and forming rack encircle shaft 5001 yet moveindependent of one-another. Forming rack 8200 is configured with anannular outer surface where a portion of the annular outer surfacescomprises rack teeth which are adapted to mesh with pinion gear 8300.The forming rack 8200 further comprises a flange portion adapted toslideably mate with a similar flange on forming rack 8110 as describedabove. Together, feed rack 8010 and form rack 8200 flanges mate withchannel in cover 8000 to permit linear movement while prevents lateralor rotational motion.

In operation, referring now to FIGS. 11A and 11B, the form pinion 8300is fixedly attached to spool 8010 b and is meshed with rack 8200 in toolmounting portion 5003. Once the feed function is complete and a clip ispresent in jaws, spool 8010 b rotates in a CW direction imparting CWrotation to pinion 8300 which in turn drives rack 8200 in a distallinear direction. Such distal linear motion of rack 8200 drives pushrod7130 in a distal linear direction which drives cam 7120 over jaws 7060forming or crimping a clip in jaws 7060, as was described above.

Rotation of pinion 8300 may be precisely controlled to impart asufficient number of rotations to advance rack 8200 a predetermineddistance to fully form a clip. Alternatively, pinion 8300 may be rotatedslowly and stopped to permit partial formation of a clip about ananatomic structure which enables movement of the clip in a less thanfully formed state about an anatomic structure. Once a clip deploymentlocation is selected, pinion 8300 may be rotated such that a clip isfully formed, occluding an anatomic structure. Once a clip is deployed,pinion 8300 is rotated in a CCW direction, which drives rack 8200 in aproximal direction, moving pushrod 7130 proximally which drives cam 7120proximally, permitting jaws 7060 to open. It is contemplated that jaw7060 opening and closing may be performed independently of clip feeding,thus allowing a user to utilize clip applier 5000 jaws 7060 as adissector.

Referring now to FIG. 12, a second expression of clip applier 5000 isshown. In the FIG. 12 expression, the tool mounting portion 5003 of theclip applier 5000 comprises a shaft assembly rotation mechanism. In theillustrated expression, for example, the surgical tool 5000 comprises arotation hub 12100 coupled to spool 8101 a. A first end of a cable 12150is fixedly attached to a superior portion rotation hub 12100 a. Cable12150 encircles and rotatingly engages shaft coupler or spool 12115where shaft coupler is fixedly attached to shaft 5001. A second end ofcable 12150 is fixedly attached to an inferior portion 12100 b of hub12100. As shown, cable 12150 twice encircles shaft coupler 12115 topermit 720° of rotation in one direction. The hub-cable-coupler assemblycontrols rotation of the shaft assembly 5001 in a clockwise (CW) andcounter-clockwise (CCW) direction based on the rotational direction ofthe hub 12100. Accordingly, rotation of the hub 12100 about a first axisis converted to rotation of the coupler 12115 about a second axis, whichis orthogonal to the first axis. As shown in FIGS. 13A and 13B, forexample, a CCW rotation of the spool 8010 a results in the hub 12100rotating in a CCW direction which in turn places tension on cable 12150at hub inferior portion 12100 b. This tension on cable 12110 at hubinferior portion 12100 b causes shaft coupler to rotate in a CWdirection as indicated in FIG. 13A. Likewise, CW rotation of hub 12100places tension on cable 12150 at superior hub end 12100 a causing CCWrotation of spool 12115 thereby causing CCW rotation of coupler 8050 andconcomitant CCW rotation of shaft 5001. It is appreciated that the spool8010 a may be rotated incrementally to provide precise rotation of theshaft. Such precise rotation may be enabled by an electrical interfacebetween the user console 1000 and clip applier 5000 driven by a softwarealgorithm, as is known and understood in the art. Shaft 5001 may berotatably fixed to mounting assembly 5010 by means of clamp 8040,comprised of clamp halves 8040 a and 8040 b. Shaft 5001 is provided witha shaft collar 8050 that is fixedly attached to shaft 5001 and coupler12115 that permits transfer of rotational force to shaft 5001. Clamphalves 8040 a and 8040 b enclose shaft collar 8050 and are provided withrecesses to permit free rotation of shaft 5001 while prohibiting shaft5001 linear motion. In the present expression, clamp collar 8050 is aprovided with an annular flange 8050 b to mate with clamp 8040 recessesto prevent axial motion.

Still referring to the FIG. 12 expression, tool mounting portion 5003 ofclip applier 5000 comprises a clip feed mechanism to feed clips intojaws 7060 as shown in FIGS. 14A and 14B. In the illustrated expressionfor example, the surgical tool 5000 comprises a rack 12110 and worm gear12210 gearing mechanism to provide the clip feed functionality. Wormgear 12210 is comprised of helical threads mounted on a shaft where theshaft is rotatingly affixed to shaft mounts 14110. Mounts 14110 permitfree rotation and prevent axial movement of worm gear 12210 shaft. Wormgear 12210 is coupled to a spool 8010 c by a cable affixed to spool 8010c at superior and inferior locations (not shown) such that rotation ofthe corresponding driven element 6020 causes the spool 8010 c to rotateapplying tension selectively to worm gear 12210 cable at either thespool 8010 c superior or inferior position depending upon spool rotationdirection. As shown in the present expression, rack 12110 moves in alinear direction and is affixed to feed bar coupler 7200. In the FIG. 12expression, the worm gear 12210 is meshed to a feed rack gear 12110,which moves in a linear direction. As shown, feeding rack 12110 isprovided with a cut-out portion configured to nestle with a similarcut-out portion on forming rack Feed rack 12110 is configured with arectangular outer surface wherein one side of the rectangular outerportion comprises the rack teeth. The feed rack 12110 further comprisesa flange portion having a slot. Tool mounting portion is furtherprovided with a rectangular pin located in cover 8000 adapted to matewith feed rack slot 12110 b such that the mating of the pin and slot12110 b maintain rack 12110 in a fixed lateral position relative to toolmounting portion 5003 while permitting linear movement.

In operation, worm gear 12210 is meshed to feed rack 12110 such thatwhen worm gear 12210 is rotated in a first or second direction, rack12110 is moved linearly in a corresponding first or second direction. Asshown in FIG. 14A, CCW rotation of spool 8010 c selectively placestension on worm gear cable causing worm gear 12210 to rotate in a CWdirection. CW rotation of worm gear 12210 imparts distal linear motionto rack 12110 which in turn moves feed bar coupler distally causing feedbar 7030 to move distally, as was described above. In the presentexpression, worm gear 12210 is rotated sufficiently to advance rack12110 distally a sufficient distance to fully advance a clip into jaws7060. Rack 12110 travel distance may vary based upon several factorse.g. clip leg length, jaw length. In the present expression, feed racktravels approximately 0.25 inches. Feed worm gear 12210 rotation may beprecisely controlled by an electrical and software interface to deliverthe exact feed rack 12110 travel necessary to feed a clip into the jaws7060. Upon delivery of a clip into the jaws or after a predeterminedamount of rotation of feed worm gear 12210, rotation of worm gear 12210is reversed to a CW direction to move feed rack 12110 in a proximaldirection, in turn moving feedbar coupler 7200 proximally, which in turnmoves feedbar 7030 proximally, as was described above. This process maybe repeated several times to accommodate a predetermined number of clipsresiding in the shaft. The software interface may be programmed to countdown the number of clips fed into the jaws and display the same to theuser and may further prevent the user from attempting to feed anotherclip once the shaft is empty. It is contemplated that the softwareinterface may alert the user when the shaft contains a predeterminedamount of clips.

Referring back to FIG. 12 and FIGS. 15A and 15B, tool mounting portion5003 of clip applier 5010 comprises a clip forming mechanism to formclips in jaws 7060. In the illustrated expression for example, thesurgical tool 5000 comprises a rack and worm gearing mechanism toprovide the clip forming functionality. A forming worm gear 12300 iscomprised of helical teeth mounted to a shaft 12330 (see FIG. 15A) whereshaft 12330 is mounted to a bell crank 12320. Worm gear 12300 is coupledto a spool 8010 b at superior and inferior portions of spool 8010 bshaft by a cable 12310 such that rotation of the corresponding drivenelement 6020 causes the spool 8010 b and worm gear 12300 to rotate in afirst direction. In the FIG. 12 expression, the worm gear 12300 ismeshed to a feed rack gear 12200, which moves in a linear direction.This mesh arrangement prevents bell crank 12320 and worm gear 12300 fromrotating when spool 8010 b is rotated. The rack gear 12200 is coupled tomale end 7130 b of pushrod 7130. Forming rack 12200 is configured with arectangular outer surface where a side of the outer surface comprisesrack teeth which are adapted to mesh with helical teeth of worm gear12300. The forming rack 12200 further comprises a flange portion havinga slot 12200 b. Tool mounting portion is further provided with arectangular pin located in cover 8000 adapted to mate with feed rackslot 12200 b such that the mating of the pin and slot 12200 b maintainrack 12200 in a fixed lateral position relative to shaft 5001 centralaxis.

In operation, referring now to FIGS. 15A and 15B, the form worm gear12300 is encircled by a cable that is fixedly attached to inferior andsuperior portions of spool 8010 b and is meshed with rack 12200 in toolmounting portion 5003. Once the feed function is complete and a clip ispresent in jaws, spool 8010 b rotates in a CCW direction imparting CCWrotation to worm gear 12300 which in turn drives rack 12200 in a distallinear direction. Such distal linear motion of rack 12200 drives pushrod7130 in a distal linear direction which drives cam 7120 over jaws 7060crimping a clip, as was described above.

Rotation of worm gear 12300 may be precisely controlled to impart asufficient number of rotations to advance rack 12200 a predetermineddistance to fully form a clip. Alternatively, worm gear 12300 may berotated slowly and stopped to permit partial formation of a clip aboutan anatomic structure which enables movement of the clip in a less thanfully formed state about an anatomic structure. Once a clip deploymentlocation is selected, worm gear 12300 may be rotated such that a clip isfully formed, occluding an anatomic structure. Once a clip is deployed,spool 8010 b is driven in a CW direction which in turn rotates worm gear12300 in a CW direction, which drives rack 12200 in a proximaldirection, moving pushrod 7130 proximally which drives cam 7120proximally, permitting jaws 7060 to open. It is contemplated that jaw7060 opening and closing may be performed independently of clip feeding,thus allowing a user to utilize clip applier 5000 as a dissector.

Referring now to FIG. 16, an exploded view of a third expression of thepresent clip applier 5000 is shown. In this expression, the clip applier5000 includes rotatable bodies or spools 8010 a, 8010 b, 8010 c and arecoupled to rotatable bodies or drive elements 6020. The spools 8010a,b,c may be formed integrally with the driven elements 6020. In otherexpressions, spools may be formed separately from the driven elements6020 provided that the spools 8010 a,b,c and the elements 6020 arefixedly coupled such that driving the elements 6020 causes rotation ofthe spools 8010 a,b,c. Each spool 8010 a,b,c is coupled to a gear trainor drive assembly for translating motion to the shaft 7010 for rotatingthe shaft, advancing a clip and forming a clip. As shown, spools 8010a,b,c interface with spool bearings 8030 seated between spools 8010a,b,c and mounting plate 5003 to facilitate smooth transfer ofrotational forced from corresponding drive elements on the robotic arm2006. The bearings 8030 may further be provided to support and stabilizethe mounting of spools 8010 a,b,c and reduce rotary friction of shaftand gears, for example.

In the FIG. 16 expression, the tool mounting portion 5003 of the clipapplier 5000 comprises a shaft assembly rotation mechanism. In theillustrated expression, for example, the surgical tool 5000 comprises arotation hub 16100 coupled to spool or pulley 16110 by cable 17150 (seeFIG. 17A). A first end of a cable 17150 is fixedly attached to asuperior portion rotation hub 16100 a. Cable 17150 encircles androtatingly engages shaft coupler or spool 16110 where shaft coupler isfixedly attached to shaft 5001. A second end of cable 17150 is fixedlyattached to an inferior portion 16100 b of hub 16100. As shown, cable17150 twice encircles shaft coupler 16110 to permit 720° of rotation inone direction. The hub-cable-coupler assembly controls rotation of theshaft assembly 5001 in a clockwise (CW) and counter-clockwise (CCW)direction based on the rotational direction of the hub 16100.Accordingly, rotation of the hub 16100 about a first axis is convertedto rotation of the coupler 16110 about a second axis, which isorthogonal to the first axis. As shown in FIGS. 17A and 17B, forexample, a CCW rotation of the spool 8010 a results in the hub 16100rotating in a CCW direction which in turn places tension on cable 17150at hub inferior portion 16100 b. This tension on cable 17150 at hubinferior portion 16100 b causes shaft coupler to rotate in a CWdirection as indicated in FIG. 17A. Likewise, CW rotation of hub 16100places tension on cable 12110 at superior hub end 16100 a causing CCWrotation of spool 16100 thereby causing CCW rotation of coupler or spool16110 and concomitant CCW rotation of shaft 5001. It is appreciated thatthe spool 8010 a may be rotated incrementally to provide preciserotation of the shaft. Such precise rotation may be enabled by anelectrical interface between the user console 1000 and clip applier 5000driven by a software algorithm, as is known and understood in the art.Shaft 5001 may be rotatably fixed to mounting assembly 5010 by means ofclamp 16040, comprised of clamp halves 16040 a and 16040 b. Shaft 5001is provided with a shaft collar 16050 that is fixedly attached to shaft5001 and coupler or spool 16110 that permits transfer of rotationalforce to shaft 5001. Clamp halves 16040 a and 16040 b enclose shaftcollar 16050 and are provided with recesses to permit free rotation ofshaft 5001 while prohibiting shaft 5001 linear motion. In the presentexpression, clamp collar 16050 is a provided with an annular fl-angel16050 b to mate with clamp 8040 recesses to prevent axial motion whilepermitting rotation.

Still referring to the FIG. 16 expression, tool mounting portion 5003 ofclip applier 5010 comprises a clip feed mechanism to feed clips intojaws 7060. In the illustrated expression for example, the surgical tool5000 comprises a feeding crank, connecting rod and slider assembly toprovide the clip feed functionality. A feeding crank 16200 is coupled toa spool 8010 b by pin 16200 b such that rotation of the correspondingdriven element 6020 causes the spool 8010 b and feed crank 16200 torotate in a first direction. In the FIG. 16 expression, the feed crank16200 is a circular crank connected to feed slider 16500 via feedconnecting rod 16300, where angular motion of feed crank 16200 isconverted to feed slider 16500 linear motion via connecting rod 16300.The feeding slider 16500 is coupled to feed bar coupler 7200 bysubstantially encircling coupler 7200 where slider 16500 is providedwith angular recesses that mate with coupler 7200 angular flanges.Coupler 7200 is fixedly attached to feedbar 7030, as was describedabove.

In operation, referring to FIGS. 18A and 18B, the feed crank 16200 isconnected to feed slider 16500 via connecting rod 16300 in tool mountingportion 5003. Feed spool 8010 b is rotated in a CCW direction which inturn rotates feed crank 16200 in a counter-clockwise direction. In theFIG. 18A expression, feed connecting rod 16300 is connected to feedcrank 16200 on a side opposite an axis defined by shaft 5001. In thisarrangement, CCW rotation of crank 16200 causes connecting rod 16300 tomove in a distal direction thereby causing slider 16500 to movedistally, causing feed bar 7030 to move distally, advancing a clip intojaws 7060. In the present expression, feed crank 16200 is rotatedsufficiently to move connecting rod 16300 and slider 16500 distally asufficient distance to fully advance a clip into the jaws 7060. Slider16500 travel distance may vary based upon several factors e.g. clip leglength, jaw length. In the present expression, feed rack travelsapproximately 0.25 inches. Feed crank 16200 rotation may be preciselycontrolled by an electrical and software interface to deliver the exactfeed slider 16500 travel necessary to feed a clip into the jaws 7060.Upon delivery of a clip into the jaws or after a predetermined amount ofrotation of feed crank 16200, rotation of crank 16200 is reversed to aCW direction to move feed connecting rod 16300 and slider 16500 in aproximal direction, in turn moving feedbar coupler 7200 proximally,which in turn moves feedbar 7030 proximally, as was described above.This process may be repeated several times to accommodate apredetermined number of clips residing in the shaft. The softwareinterface may be programmed to count down the number of clips fed intothe jaws and display the same to the user and may further prevent theuser from attempting to feed another clip once the shaft is empty. It iscontemplated that the software interface may alert the user when theshaft contains a predetermined amount of clips.

Referring back to FIG. 16, tool mounting portion 5003 of clip applier5000 comprises a clip forming mechanism to form clips in jaws 7060. Inthe illustrated expression for example, the surgical tool 5000 comprisesa crank, connecting rod and forming slider to provide the clip formingfunctionality. Forming crank 16600 is coupled to spool 8010 c by pin16600 b such that rotation of the corresponding driven element 6020causes the spool 8010 b and forming crank 16600 to rotate in a firstdirection. In the FIG. 16 expression, the forming crank 1600 is inmechanical communication with form slider 16700 via form crank. Angularrotation of crank 16600 causes linear motion of connecting rod 16800which moves form slider 16700 in a linear direction. Form slider 16700is comprised of slider halves 16700 a and 16700 b that substantiallyenclose about and couple to male end 7130 b of pushrod 7130 as wasdescribed above.

In operation, referring now to FIGS. 19A and 19B, the form crank 16600is fixedly attached to spool 8010 b by pin 16600 b in tool mountingportion 5003. Once the feed function is complete and a clip is presentin jaws, spool 8010 c rotates in a CCW direction imparting CCW rotationto form crank 16600. Connecting rod 16800 is affixed to crank 16600 on asurface between spool 8010 c shaft and clip applier shaft 5001 such thatCCW rotation of crank 16600 imparts distal linear motion (in a directiontowards jaws 7060) to forming connecting rod 16800. Distal linearmovement of connecting rod 16800 pulls form slider 16700 in a distallinear direction which drives pushrod 7130 in a distal linear directionwhich drives cam 7120 over jaws 7060 thereby crimping a clip in the jaws7060, as was described above.

Rotation of crank 16600 may be precisely controlled to impart asufficient number of rotations to move connecting rod 16800 and slider16700 a predetermined distance to fully form a clip. Alternatively,crank 16600 may be rotated slowly and stopped to permit partialformation of a clip about an anatomic structure which enables movementof the clip in a less than fully formed state about an anatomicstructure. Once a clip deployment location is selected, crank 16600 maybe rotated such that a clip is fully formed, occluding an anatomicstructure. Once a clip is deployed, crank 16600 is rotated in a CWdirection, connecting rod 16800 and slider 16700 in a proximaldirection, moving pushrod 7130 proximally which drives cam 7120proximally, permitting jaws 7060 to open. It is contemplated that jaw7060 opening and closing may be performed independently of clip feeding,thus allowing a user to utilize clip applier 5000 as a dissector.

Some aspects may be described using the expression “coupled” and“connected” along with their derivatives. It should be understood thatthese terms are not intended as synonyms for each other. For example,some aspects may be described using the term “connected” to indicatethat two or more elements are in direct physical or electrical contactwith each other. In another example, some aspects may be described usingthe term “coupled” to indicate that two or more elements are in directphysical or electrical contact. The term “coupled,” however, also maymean that two or more elements are not in direct contact with eachother, but yet still co-operate or interact with each other.

While the examples herein are described mainly in the context ofmechanical clip applier instruments, it should be understood that theteachings herein may be readily applied to a variety of other types ofmedical instruments. By way of example only, the teachings herein may bereadily applied to tissue graspers, tissue scissors, surgicaldissectors, or a variety of energy based surgical instruments, etc. Itshould also be understood that the teachings herein may be readilyapplied to any of the instruments described in any of the referencescited herein, such that the teachings herein may be readily combinedwith the teachings of any of the references cited herein in numerousways. Other types of instruments into which the teachings herein may beincorporated will be apparent to those of ordinary skill in the art.

It should be appreciated that any patent, publication, or otherdisclosure material, in whole or in part, that is said to beincorporated by reference herein is incorporated herein only to theextent that the incorporated material does not conflict with existingdefinitions, statements, or other disclosure material set forth in thisdisclosure. As such, and to the extent necessary, the disclosure asexplicitly set forth herein supersedes any conflicting materialincorporated herein by reference. Any material, or portion thereof, thatis said to be incorporated by reference herein, but which conflicts withexisting definitions, statements, or other disclosure material set forthherein will only be incorporated to the extent that no conflict arisesbetween that incorporated material and the existing disclosure material.

Embodiments or expressions of devices and components thereof disclosedherein have application in conventional endoscopic and open surgicalinstrumentation as well as application in robotic-assisted surgery.

Embodiments of the devices disclosed herein can be designed to bedisposed of after a single use, or they can be designed to be usedmultiple times. Embodiments may, in either or both cases, bereconditioned for reuse after at least one use. Reconditioning mayinclude any combination of the steps of disassembly of the device,followed by cleaning or replacement of particular pieces, and subsequentreassembly. In particular, embodiments of the device may bedisassembled, and any number of the particular pieces or parts of thedevice may be selectively replaced or removed in any combination. Uponcleaning and/or replacement of particular parts, embodiments of thedevice may be reassembled for subsequent use either at a reconditioningfacility, or by a surgical team immediately prior to a surgicalprocedure. Those skilled in the art will appreciate that reconditioningof a device may utilize a variety of techniques for disassembly,cleaning/replacement, and reassembly. Use of such techniques, and theresulting reconditioned device, are all within the scope of the presentapplication.

By way of example only, embodiments described herein may be processedbefore surgery. First, a new or used instrument may be obtained and ifnecessary cleaned. The instrument may then be sterilized. In onesterilization technique, the instrument is placed in a closed and sealedcontainer, such as a plastic or TYVEK bag. The container and instrumentmay then be placed in a field of radiation that can penetrate thecontainer, such as gamma radiation, x-rays, or high-energy electrons.The radiation may kill bacteria on the instrument and in the container.The sterilized instrument may then be stored in the sterile container.The sealed container may keep the instrument sterile until it is openedin a medical facility. A device may also be sterilized using any othertechnique known in the art, including but not limited to beta or gammaradiation, ethylene oxide, or steam.

Having shown and described various embodiments of devices and componentsthereof, further adaptations of the methods and systems described hereinmay be accomplished by appropriate modifications by one of ordinaryskill in the art without departing from the scope of the presentinvention. Several of such potential modifications have been mentioned,and others will be apparent to those skilled in the art. For instance,the examples, embodiments, geometrics, materials, dimensions, ratios,steps, and the like discussed above are illustrative and are notrequired. Accordingly, the scope of the present invention should beconsidered in terms of the following claims and is understood not to belimited to the details of structure and operation shown and described inthe specification and drawings.

While certain features of the aspects have been illustrated as describedherein, many modifications, substitutions, changes and equivalents willnow occur to those skilled in the art. It is therefore to be understoodthat the appended claims are intended to cover all such modificationsand changes as fall within the true scope of the disclosed embodiments.

I claim:
 1. A surgical fastener deploying instrument comprising: an endeffector comprising a clip applier having opposed jaws capable ofsupporting and deploying a clip onto tissue; a shaft assembly having aproximal end and a distal end, the shaft assembly capable of rotationabout an axis, the shaft assembly containing a plurality of clips andsupporting the end effector at the distal end; and a housing disposed atthe proximal end of the shaft assembly, the housing having first,second, and third rotary inputs configured to couple with a roboticsurgical system, the housing containing a first drive train inmechanical communication with the first rotary input, the first drivetrain configured to control rotation of the shaft assembly; a seconddrive train in mechanical communication with the second rotary input,the second drive train comprising a gear drive train configured tocontrol feeding of the clip from the shaft assembly into the jaws of theend effector; and a third drive train in mechanical communication withthe third rotary input, the third drive train comprising a gear drivetrain configured to crimp the clip in the jaws independently of thesecond drive train feeding the clip.
 2. The instrument of claim 1,wherein the first drive train comprises a pinion in mechanicalcommunication with a worm gear, wherein the worm gear is affixed to theshaft assembly such that rotation of the pinion in a first directionrotates the shaft assembly in a first direction.
 3. The instrument ofclaim 1, wherein the second drive train comprises a second pinion inmechanical communication with a first rack, wherein the first rack ismeshed with a fastener feed assembly such that rotation of the secondpinion moves the rack in a linear direction advancing the fastener inthe shaft assembly.
 4. The instrument of claim 1, wherein the thirddrive train comprises a third pinion in mechanical communication with asecond rack where the second rack is operably connected to the jaws suchthat rotation of the third pinion moves the second rack in a lineardirection actuating the jaw assembly.
 5. The surgical fastener deployinginstrument of claim 1, wherein the third drive train is furtherconfigured to open and close the jaws without a clip being positionedbetween the jaws.